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930832.pdfCITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME NAME OF BUSINESS V3K15C0 w MAILING ADDRESS I�t I�)-°i 0Lvvv%_PtL VIr=w .�2 vv\otoDS I itj1) W ADDRESS x ¢a CITY ZIP NAME ADDRESS Iiol► rr CITY 9-,Z STATE LICENSE NUN i " v F-LtLII27C LEPHONENUMBER '7 07S' - LI 3 4p LI iJ wt V-\ Cz i ►'v ��- V I F ��1 2 ZIP TELEPHONE NUMBER uJ 1� arS 1 52 3 t B R EXPIRATION ATE /`�1 �Cl Leoal Description of Property - include all easements Property Tax Account Parcel No. L_1 NEW ADDITION REMODEL EPAIR DEMOLISH �l GARAGE (CARPORT (TYPE OF USE. B Llll. RESIDENTIAL COMMERCIAL ElAPT. BLDG. ❑ GRADING CYOS. ❑WOODSTOVE INSERT ElRETAINING WALL/ ROCKERY INESS OR ACTIVITY) EXPLA PLUMBING MECHANICAL ElSIGN FENCE ( x _FT) SWIM POOL HOT TUB/SPA ElRENEWAL NUMBER I NUMBER OF INUMBER CRITICAL OF DWELLING AREAS STORIES UNITS DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) r HEAT SOURCE: Plan Check No. GLAZING USE PERMIT ©� ZONE �j NUMBER 9308a.+�r: joBsu ADDRESS LEGAL DESCRIPTION CHECKLEGAL DESCRIPTION CHECK SUBDIVISION O LID NO r LID NO / PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP EXISTING REQUIRED DEDICATION PROPOSED METER SIZE LINE SIZE NO. OF FIXTURES ENGINEERING MEMO DATED TESCP Approved ❑ RW Permit Required ❑ Street Use Permit Req'd ❑ Inspection Required ❑ Sidewalk Required ❑ cc w PRV REQUIRED ¢ YES ❑ NO ❑ 3 Z z cc w Z 0 Z w REVIEWED BY SIGN AREA SEPA REVIEW ADB NO. ALLOWED PROPOSED COMPLETE EXEMPT SHORELINE# EXP VARIANCE OR CU PLANNING REVIEW BY DATE SETBACKS — FEET l HEIGHT I LOT COVERAGE FRONT SIDE REAR aHECKED BY TYPE OF CONSTRUCTION CODE UCCUPANT GR SPECIAL INSPECTOR AREA OCCUPANT REQUIRED YES LOAD ❑ PROGRESS INSPECTIONS PER UBC 305 FINAL INSPECTION REQUIRED VALUATION JPLAN CHECK FEE BUILDING % PLUMBING This Permit covers work to be done on private property ONLY. Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. Permit Application: 180 Days Permit Limit: 1 Year - Provided Work is Started Within 180 Days "Applicant, on behalf of his or her spouse, heirs, assigns and In successors in interest, agrees to indemnify, defend and hold W harmless the City of Edmonds, Washington, its officials, s employees, and agents from any and all claims for damages of a whatever nature, arising directly or indirectly from the issuance x of this permit. Issuance of this permit shall not be deemed to omodify, waive or reduce any requirement of any city ordinance x nor limit in any way the City's ability to enforce any ordinance provision." k I d that I have read this application' that the MECHANICAL GRADINGIFILL STATE SURCHARGE STORM DRAINAGE FEE ENG. INSPECTION FEE l PLAN CHECK DEPOSIT TOTAL AMOUNT DUE I hereby ac now a ge ATTENTION information given is correct; and that I am the owner, or the duly authorized agent of the owner. 1 agree to comply with city and THIS PERMIT state laws regulating construction; and in doing the work authoriz- AUTHORIZES ed thereby, no person will be ployed in violation of the Labor ONLY THE Code of the State of Washing relating to Workmen's Compensa- WORK NOTED tion Insurance and RCW 18. INSPECTION RE 10 JNER OR AGENT( DATE SIGNED DEPARTMENT 11 j CITY OF l-� EDMONDS CALL FOR ATTENTION INSPECTION IT IS UNLAWI=UL T SE OR OCCUPY A BUILDING OR STRUCTURE ��� ®a2® UNTIL A FINAL IN E ON HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. 102.87 i FE w LL Z z 0 J_ co m APPLICATION APPROVAL ) l' This application is not a permit until signed by the Building Official or his/her Deputy; and fees are paid, and receipt is acknowledged in space provided. OFFICI SO'NK1 J / • � � TE ASED BY DATE ORIGINAL —File YELLOW —Inspect r U PINK — Ohner GOLD —Assess .. _ _ _ _ � . '..�, .-... >•n+- M+s t ..'` _ _ . �+'t�.� > '<r"T�r4i �rrli�r.zpr^rP^'�Yr.^'y1���T f it' � . T. .... _ _. / .,:v�� � n :,'^r-^r l'�" r.i.���r �r! zs' J .t!`<-r"i'zz �. arlyTi" rig. i.My'Sp.l�'"-.1.r`!�. ii��{7.ni.\^;'LN/��.Q�R�77' •� YC} ��- . �. _.._ ;,